Latest / Becker’s Healthcare Digital Health + Health IT / Kay Burke, Chief Nursing Informatics Officer at UCSF Health Informatics

Transcript

Kay Burke, Chief Nursing Informatics Officer at UCSF Health Informatics · Becker’s Healthcare Digital Health + Health IT

• 0:00
  - Prepare to dive into the forefront
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  of healthcare innovation at our 14th annual meeting coming
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  through 11th at the Hyatt Regency in Chicago, with thousands
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  of industry leaders converging over four dynamic days
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  of discussions on crucial topics from health IT
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  to executive leadership.
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  It's where the future of healthcare takes shape.
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  We can't wait to connect with you in person
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  and engage in these important conversations.
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  - Welcome to the Becker's Healthcare Podcast, made
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  for the people who power US healthcare.
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  I'm Molly Gamble at Becker's,
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  and today I am sitting down with K Burke
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  to learn more about the representation of nursing
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  and informatics and leadership in the field.
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  Kay is the Chief Nursing Informatics Officer
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  for UCSF Health Informatics.
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  Kay, welcome to the podcast. Thanks
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  so much for being my guest.
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  How are you today? And where does podcast find you?
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  - Hi, Molly. Thanks so much
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  for inviting me to be your guest.
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  I am doing fabulous.
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  It's, it's a rare 70 degree day in San Francisco,
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  and so I am looking forward
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  to a beautiful, relaxing weekend.
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  How are you?
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  - I'm doing well. Uh,
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  we are about 30 degrees different here in Chicago.
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  Um, but , you know, we've had a very mild winter,
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  so I can't complain now.
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  Do you know what I mean? Um, yeah, we've had it pretty good.
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  You know, you mentioned San Francisco.
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  For listeners who might be less familiar
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  with UCSF Health Informatics,
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  can you share a few key facts about the organization just
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  to help our listeners better reacquaint themselves?
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  Yeah,
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  - Absolutely.
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  So, I'll, I'll start with sort of UCSF as an organization,
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  and then I'll delve into our informatics department.
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  Um, so UCSF, which I always assume everyone knows, stands
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  for the University of California San Francisco,
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  but just in case, wanted to kind of spell that out.
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  Um, so we're an academic health system.
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  We serve the Greater Bay Area
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  and, uh, UCSF has, uh, three core mission areas, um,
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  that includes health
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  or the clinical care delivery arm, which is
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  where I'm housed, uh, as well as research and education.
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  So we as an organization are really committed to ensuring
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  that those are all interconnected and aligned.
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  It's really part of who we are and what we do.
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  And, uh, we have several campuses across, um, San Francisco,
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  and we actually are expanding our
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  footprint, which is really exciting.
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  We just acquire two amazing community hospitals.
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  So that's, that's a bit about UCSF
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  and, uh, health informatics is, it's really kind
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  of a key function, I think, within the health system.
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  Um, we're actually part of information technology.
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  Um, that's our division though we work really,
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  really closely with, with operations
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  and the clinical departments.
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  And our portfolio has several verticals, one of which,
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  of course is nursing informatics, which is what I oversee.
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  Uh, we have a, an incredible team of informaticists.
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  We, uh, work very closely with the technical analysts, uh,
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  as well as, as I mentioned, our clinical colleagues
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  and, you know, not just nurses,
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  but, uh, nursing informatics supports,
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  advanced practice providers, including nurse practitioners
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  as well as allied health professionals such as pt, ot,
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  you know, speech register, registered dieticians,
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  social workers, and the like.
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  Um, and, you know, given that all
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  of these roles use digital tools
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  and information systems to do their daily jobs
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  and carry out their, you know,
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  respective professional practice, they,
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  they really require the support
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  and service of informatics professionals.
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  And we do a lot, you know, some,
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  some describe informatics kind of as the bridge
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  between clinicians and it,
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  and we, we have a, a leg in both worlds.
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  And, um, and
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  because of this, we understand the clinical workflows
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  and the problems that need, need solving, you know, whether
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  that's an electronic health record design solution
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  or, you know, user adoption
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  or the implementation of, of large scale projects.
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  And what we do is we help ensure that the,
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  the IT application experts really have the requirements
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  needed to, to build said solution.
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  And so everyone on my team is an rn, you know,
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  most are board certified in nursing informatics.
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  And, uh, so yeah, that's, uh, that's our story.
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  - Okay. I, you just covered that very concisely,
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  but UCSF, I mean, when you talked about some of the,
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  the three arms and then research being one of them, um,
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  the research coming out of UCSF is, is such a long list
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  of big milestones and discoveries.
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  I, I think chronic pain is a condition stems from UCSF
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  research, uh, so much advancements toward, uh, AIDS
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  and treatment and identifying symptoms of aids.
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  So, I mean, I encourage listeners if they're less familiar
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  to, to check in, look into that
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  because, um, you summarized it really well.
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  Kay. But behind the scenes, I know that it's a,
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  it's a really long roster of different achievements
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  and milestones from your research.
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  - Yeah, I appreciate you saying that.
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  I, um, I myself am incredibly impressed by,
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  and humbled by the body of research that comes out of UCSF,
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  the funding that we have been able to achieve to
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  perpetuate incredible research.
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  I always say that, you know,
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  it always feels like we're sort, you know, uh,
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  curing cancer in the backyard.
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  Uh, there are people that come from around the world
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  to be part of clinical trials and receive treatment at UCSF.
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  So I appreciate that, um, emphatic point that you made,
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  because sometimes I,
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  I undersell the research endeavors at UCSF,
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  and, um, I do think it's, uh,
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  it's worth noting. So thank you for saying that.
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  - Yeah, and I, I wasn't implying underselling at all.
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  It was more in recent conversations,
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  and I, I even undersell just now.
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  I mean, when I said advancements around treatment of aids,
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  I mean, UCSF co-discovered aids, so, um,
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  some landmark developments there.
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  But, um, you know, Kay, I wanted to dig into
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  and double click on your role with nursing and informatics.
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  Nursing long been underrepresented in the field
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  of healthcare informatics.
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  And then you have nurses playing such a crucial
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  role in patient care.
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  They have so many valuable insights into healthcare
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  processes that can go overlooked quite often in,
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  in the development
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  and implementation of informatics solutions.
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  How have you seen this change, either at UCSF specifically,
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  or if you take a step back in the industry at large?
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  - Yeah, I mean, it's, it's a very interesting observation.
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  Um, I certainly share it.
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  I, I have seen this change over the years
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  and, um, I mean, I'll share with you a little bit about my
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  personal, um, journey in the field.
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  Uh, so when I first got into informatics back in 2009,
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  often there were CMIO roles,
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  and in some cases, you know,
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  additional medical informatics leaders like associates,
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  CMIOs and directors of medical informatics,
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  but rarely, if ever A-C-N-I-O.
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  And this was the case when I started.
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  And, uh, while I was on
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  an incredible nursing informatics team,
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  there was not A-C-N-I-O at the organization, uh, you know,
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  doctors, nurses, pharmacists, we all worked
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  on EHR implementation projects together,
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  but the leaders were almost always positioned.
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  So when I first became A-C-N-I-O myself,
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  and this was in 2014, I was excited.
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  I was glad that the organization had A-C-N-I-O role.
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  I was thrilled to be afforded the
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  opportunity to be in the role.
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  Um, my role reported to the CMIO,
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  and, you know, while he was an incredible partner, the,
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  the org chart illustrated who's driving the
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  bus, so to speak.
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  And so therefore, to your point,
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  nursing was underrepresented, not just in the field
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  of healthcare informatics,
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  but in decision making that impacted nurses themselves
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  since there were not as many, if any,
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  at all seats at the leadership table for nurses.
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  Uh, so when I started here at UCSF, which was in 2017,
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  I was hired as the inaugural CNIO.
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  So there had never been A-C-N-I-O before.
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  Um, and subsequently no recognized, you know,
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  nursing informatics team.
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  And it took a lot as it as it does, right,
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  to build a program and a team, especially while also
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  educating the organization about the value
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  of nursing informatics.
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  And it is tough to constantly try to demonstrate value
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  of your role and your team's role
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  and building business cases for additional positions
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  and, you know, upskilling new hires
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  and delivering on key priorities.
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  Um, but I will say
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  now we are well positioned in the organization
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  to be at the table, right?
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  To help formulate decisions and best practices
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  and technology design
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  and partner with nurse executives to ensure
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  that our clinicians are well supported
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  and have the right tools and workflows to, to do their jobs.
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  Um, but I will say,
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  I'm gonna just say a quick story, if that's okay, .
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  Yeah, absolutely. It's actually, it's this torch
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  that I carry often, um, externally.
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  And, uh, so recently at a, at a conference, I spoke
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  to an audience of about a hundred plus or minus, uh, CNOs
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  and, and CE Chief nurse executive.
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  And at one point I asked for a show of hands, I said,
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  how many of you have A-C-M-I-O at your organization?
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  And most raised their hands. Mm-Hmm, .
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  And then I asked, you know, of you who raised your hands?
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  How many of you also have A-C-N-I-O?
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  And honestly, Molly most hands dropped. Mm.
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  And then I charged them all.
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  I said, it is very important
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  that you advocate for this role.
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  I mean, it is a matter of, of inequity at this point.
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  I mean, at any organization, there are more nurses
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  and allied health professionals than doctors, right?
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  So then I said, inequitable representation,
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  if not challenged by you, is perpetuated by you.
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  Mm-Hmm, . Mm-hmm. . And there was
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  like, certainly discomfort .
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  But, you know, at the end of, at the end of the conference,
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  there was a line out the door, you know, of CNEs
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  and CNOs who were, you know, wanting to talk to me about,
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  like how to justify the, you know,
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  how do you build the business case of, you know,
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  having A-C-N-I-O at your organization?
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  Mm-Hmm, . So, um,
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  and I actually did this one other quick, quick story.
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  I was actually a summit hosted by a vendor.
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  And, you know, the, the opening keynote was a CEO.
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  And he said he proudly introduced the first new ever CMIO.
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  So imagine what I did.
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  I caught him at the coffee break,
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  and I was like, congratulations for hiring A-C-M-I-O.
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  That's great. And I was like, so where's your CNIO?
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  And yes, rhetorical for sure, our little, little flippant,
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  but catch my draft.
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  It just, it doesn't, just doesn't make sense to me.
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  You know? So, you know, it's, it's an ongoing, um,
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  advocacy, I won't say battle 'cause 'cause it's not a fight.
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  I mean, I, I will say that, you know, partnerships
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  with medical informatics professionals, it's very key.
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  It's not an us and them, it's not Mm-Hmm.
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  binary, um, you know,
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  effective informatics teams,
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  teams rely on collaborative work and, and relationships.
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  Um, it just, uh, continues to be, um,
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  this journey that does not yet have,
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  uh, an end point.
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  But I think we c nios, nursing informatics professionals,
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  nurses themselves are all kind
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  of continuing to march the march.
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  So we'll get there. .
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  - I think that's such an important perspective. Kay.
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  You know, I think health systems
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  and hospitals, you saw, I mean, decades ago,
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  it was typically a hospital administrator right at the
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  top of the organization.
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  A lot of this has changed. Now,
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  the organizational structures and titles and positions,
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  and there's some that are fixtures, I think they're out,
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  they're, they're given at most organizations,
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  what I've always been more intrigued by is,
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  what you just touched on, is these roles that are emerging.
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  Um, some organizations, it starts off with just a few
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  and what, whatever the title may be,
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  but it's this sweet spot of time where it's not yet a given,
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  it's not yet widespread.
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  And I think, like you just indicated, there's a lot
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  of hard work there, um, in terms
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  of helping organizations move forward, progress and,
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  and better have representation for some really,
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  really key professionals in their organizations.
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  Um, and it also, like you said, it takes,
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  there's soft skills there that come up, whether it's,
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  you know, trying to help people
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  and bring them along in a way that isn't shaming them
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  or isn't, you know, tt
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  but helping them see that congratulations,
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  you have established the CMIO role.
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  That is a huge accomplishment now ,
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  you know, and keep it moving.
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  Right, . Yeah.
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  So I think it, it's really helpful that you touched on that.
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  Let's talk about leadership in, in your position.
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  I'm curious what you consider the special sauce, so to say.
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  Uh, I use that term because sometimes when I ask about
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  leadership, I, I'm striving to understand the traits
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  beyond those universally important ones.
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  You know, communication skills, listening, integrity.
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  Um, what leadership traits
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  or qualifications do you, are you really craving
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  and do you think really hold exceptional significance in
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  this position as CNIO?
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  - Yeah, I mean, I, I love the special sauce term
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  as an aside, despite being an SF for about six years,
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  I am a newly minted in and out fan,
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  and their special sauce is really worth pipe .
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  - I, I, you put that together. Funny
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  - .
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  Um, but leadership is special sauce.
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  It's, it is, I mean, all the things that you mentioned, it's
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  communication and, you know, integrity, authenticity.
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  Um, but I feel like a key characteristic
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  of a successful informatics executive is really change
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  management and relationship building.
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  You know, like there's this proliferation of technology
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  and digital tools in the clinical environment,
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  and there's often resistance,
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  or in some cases, fear, to be honest with you.
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  And nurses in particular don't want
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  to be technology experts.
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  It's not what they went to nursing school for.
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  They wanna take care of patients and new ways
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  or different ways of using technology or innovating to do.
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  So. It's, it's not always popular, right?
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  It's, it's, it's really incredibly important
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  to like empower nurses
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  and nurse leaders to be part of, of change.
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  And, um, so trust is, I think of, you know,
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  paramount importance
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  and building those trusting relationships is not
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  always an easy feat.
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  Um, it's funny, I know it sounds cheesy,
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  but I often start presentations with this quote from,
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  you know, Angela McBride.
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  And it's, it talks about, it says something like,
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  there's no aspect of nursing that will be untouched
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  by the informatics revolution that is in progress.
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  But I like it because people need
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  to be part of a revolution.
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  You know, they need to have avenues to contribute
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  to digital transformation.
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  And if you're, if you're A-C-N-I-O
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  or a nursing informatics, you know, professional, you need
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  to, you need to help create those inroads.
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  And so that's why I think number one is change management
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  and that relationship building
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  and being trustworthy, that's
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  probably the most critical secret sauce.
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  Um, for CNI os, I'd say on the heels of
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  that is, is strategy.
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  So like, I'm also, often in my role, I'm one step ahead
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  of the conversation, so I'm thinking proactively about the
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  problems I'm hearing and the solutions
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  that I can anticipate.
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  You know, so like this informatics is a bridge, right?
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  Between clinicians
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  and it, so when we hear from clinicians
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  or operations that, you know,
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  fill in the blank is an issue, right?
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  Uh, let's say an unfavorable quality trend
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  or a patient safety issue,
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  or throughput, bottleneck,
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  whatever you're hearing in different committees and councils
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  and forums, and then we can start to think through potential
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  interventions that might be needed to solve for, you know,
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  X problem that you just heard.
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  And, and so I think being strategic, it, it's not unique to
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  successful leaders right?
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  Outside of informatics,
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  but I do think it's particularly
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  important in A-C-N-I-O role.
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  So I would say two secret sauces.
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  One, the change management and relationship building,
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  and then probably, you know, being proactive
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  and strategic. Mm-Hmm.
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  - , what I'm also hearing there is when you
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  talked about the, the,
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  that great quote about the revolution, helping,
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  helping your team be proactive in how technology can fit in.
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  And they are more in the driver's seat of making those calls
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  and connecting those dots versus simply reacting, right?
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  I think so much of the anxiety around AI is
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  that it's gonna be put to use in ways that will surprise us,
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  or stun us or disappoint us, and we'll have to go back and,
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  and fix it and admit we might have been wrong.
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  But I think, Kay, what I'm picking up on you saying is
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  that if people are follow along with you
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  and thinking ahead in a similar way, they might be able
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  to better have ideas about how technology and informatics
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  and tools and AI can be adopted versus
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  simply reacting to them after the fact.
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  Is that, is that a fair read on things?
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  - Absolutely. I mean, I love how you said dot connecting
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  because, uh, I, I've heard
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  that informaticists are expert dot connectors.
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  Um, in fact, my CMIO, um, colleague
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  and very, very close trusted partner, uh, at UCSF,
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  he always says that we pour the coffee ,
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  so dot connecting coffee pours.
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  I think, um, it's also no one in a forum of
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  clinical or operational leaders are asking
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  for something like ai, right?
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  There's, there's a need to demystify
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  a capability such as ai.
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  So when you're, as I was saying,
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  you're hearing these problems
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  and then you try to think about
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  how you deliver solutions using, you know, a myriad
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  of capabilities including ai.
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  And so then when you come back with a suggested
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  or recommended solution,
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  and it happens to be ai,
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  you get the buy-in, right?
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  Because it's not like, okay, I'm gonna push AI
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  or deliver AI on you.
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  Mm. It's more I heard you
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  mm-Hmm, , I heard what you said.
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  I know this is a problem. This is a possible tool in the
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  toolkit to solve your problem.
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  It happens to be ai, you know what I mean?
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  We, we ensure that there is, you know,
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  ethical trustworthiness when we deliver ai.
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  And it's sort of like just being able to help bring along
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  your, um, your leaders at a healthcare institution,
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  uh, and, and kind
• 18:59
  of essentially educating them along
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  the way. Mm-Hmm. .
• 19:02
  - Mm-Hmm. - .
• 19:04
  - Okay. It's been so interesting catching up with you.
• 19:07
  And I, I really appreciate these glimpses
• 19:09
  into your work and your role.
• 19:10
  Do you have any closing thoughts for our listeners
• 19:12
  or a message you'd like to leave them with as we wind down?
• 19:17
  - Uh, yes. I just wanna say one thing.
• 19:19
  'cause I, I often share this at the closing of,
• 19:22
  of various kind of presentations with, certainly
• 19:25
  as I mentioned, informatics, the way
• 19:28
  that healthcare is digitally transforming
• 19:32
  this environment requires
• 19:33
  that we have nursing informatics professionals and teams
• 19:36
  and structures and roles like mine.
• 19:39
  But it also means that in addition
• 19:40
  to having nursing informatics leaders
• 19:43
  and specialists, we really need
• 19:45
  to start thinking about building out informatics
• 19:48
  competencies at the bedside to the professional nurse.
• 19:53
  Like, we need to embed informatics principles in
• 19:56
  undergraduate programs and graduate education.
• 19:59
  Like we need to create fellowships or champion programs,
• 20:02
  or whatever you call it, you know, communities of practice
• 20:05
  and development opportunities to understand informatics.
• 20:09
  Like it's not just about checking me,
• 20:11
  I have A-C-N-I-O at my institution box.
• 20:15
  It's, it's really about educating
• 20:16
  and enculturating every single clinician
• 20:18
  who touches a patient to be part of this sort of,
• 20:21
  you know, new world order.
• 20:24
  Mm-Hmm. of, you know, the future of healthcare
• 20:26
  and, um, the revolution,
• 20:28
  if you will, Mm-Hmm, .
• 20:29
  So I do think it's more than just having nursing informatics
• 20:32
  as a team or as you know, as roles, it's really kind
• 20:35
  of infusing informatics competencies at all levels
• 20:38
  of professional practice.
• 20:41
  - That's a, that's a great note to add end on.
• 20:43
  And I know that'll take the cooperation
• 20:45
  and collaboration of numerous stakeholders.
• 20:47
  You just hit on a few of them with higher education and,
• 20:49
  and different training programs,
• 20:51
  but a, a really important idea to close with.
• 20:54
  - Great. - Kay, thank you so much for being our guest.
• 20:58
  I hope we can catch up again soon.
• 21:00
  This has been Kay Burke, CNIO
• 21:03
  with UCSF health informatics.
• 21:06
  Kay. I just wish you continued success in your role
• 21:08
  and keep up the good fight with expanding
• 21:12
  CNIs at health systems across the us.
• 21:14
  I know it sounds like you're putting
• 21:15
  a lot of effort into that.
• 21:17
  And, uh, I hope you will continue
• 21:18
  and others will join you in that effort too.
• 21:20
  - Well, thanks, Molly. This has been super enjoyable.
• 21:23
  I really appreciate the invitation to join you this morning.
• 21:26
  - Likewise. Thank you so much. Kay.
• 21:28
  - Thanks. Have a great day. Bye.